Clinical decision support for immunization (CDSi)

Immunization clinical decision support (CDS), more commonly referred to as evaluation and forecasting, is an automated process that determines the recommended immunizations needed for a patient and delivers those recommendations to the healthcare provider. Health Information Systems (HIS), which include Immunization Information Systems (IIS), Electronic Health Records (EHRs), and Health Information Exchanges (HIEs), create CDS tools based on schedules and guidelines developed by the Advisory Committee on Immunization Practices (ACIP), a federal advisory committee responsible for providing expert external advice and guidance on the use of vaccines and related agents for control of vaccine-preventable disease in the United States. ACIP recommendations include age for vaccine administration, number of doses, dosing interval, and precautions and contraindications.After ACIP recommendations are published, technical and clinical subject matter experts (SMEs) work to interpret and integrate them into their CDS engines. New ACIP schedule changes are currently communicated only through scientific language, in publications like the Morbidity and Mortality Weekly Report (MMWR) and the Epidemiology and Prevention of Vaccine-Preventable Diseases (\ue2\u20ac\u153The Pink Book\ue2\u20ac?). The translation of that scientific language into technical logic that can be processed within CDS engines is a time-consuming and complex process that happens mostly independently within the different HIS. Because interpretation of clinically-written ACIP recommendations can be challenging, CDS engine outputs often vary and do not always match the expectations of clinical SMEs.CS234894-APublication date from document properties.cdsi-brochure.pd

Logic specification for ACIP recommendations

Currently, Health Information Systems (HIS) \u2013 which can include Health Information Exchanges (HIEs), IIS and Electronic Health Records (EHRs) \u2013 provide healthcare providers with immunization evaluation and forecasting tools designed to automatically determine the recommended childhood immunizations needed when a patient presents for vaccination. These recommendations are developed by the Advisory Committee on Immunization Practices (ACIP). ACIP is a federal advisory committee responsible for providing expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) and the Secretary of the U.S. Department of Health and Human Services (DHHS) on use of vaccines and related agents for control of vaccine-preventable disease in the United States. Recommendations include age for vaccine administration, number of doses, dosing interval, and precautions and contraindications.After ACIP recommendations are published, technical and clinical subject matter experts (SMEs) work to interpret and integrate them into their evaluation and forecasting engines. An example of an evaluation and forecasting engine is a tool an IIS might use to alert a physician that a presenting child is overdue for a Measles, Mumps, and Rubella (MMR) vaccination. New ACIP schedule changes are currently communicated only through clinical language, in publications like the Morbidity and Mortality Weekly Report (MMWR) and the Epidemiology and Prevention of Vaccine-Preventable Diseases ("The Pink Book"). The translation of that clinical language into technical logic that is processed within evaluation and forecasting engines is a time- consuming and complex process that happens mostly independently within the different HIS. Due to the challenge of interpreting clinically-written ACIP recommendations, clinical decision support (CDS) engine outputs often vary and do not always match the expectations of clinical SMEs.In an effort to harmonize the outcomes of existing HIS CDS tools, the Immunization Information System Support Branch (IISSB) at the CDC funded the Clinical Decision Support for Immunization (CDSi) Project to develop new clinical decision aids4 for each vaccine on the children\u2019s immunization schedule to:\uf0b7 Make it easier to develop and maintain immunization evaluation and forecasting products\uf0b7 Ensure a patient\u2019s immunization status is current, accurate, consistent, and readily available\uf0b7 Increase the accuracy and consistency of immunization evaluation and forecasting\uf0b7 Improve the timeliness of accommodating new and changed ACIP recommendationsThe outcome of enabling the above results is to ensure that patients receive proper immunizations, i.e., \u201cthe right immunization at the right time.\u201d201

Logic specification for ACIP recommendations

In 2019, approximately 96% of U.S. children under the age of six participated1 in an Immunization Information System (IIS), an increase from 82% in 2010. 2 Adolescent participation in 2019 was 82%, up from 60% in 2010. Adult participation in 2019 increased to 60% up from 22% in 2010. Given this widespread IIS participation, it is important that each patient\u2019s immunization record is consistent and up to date within an IIS.Health Information Systems (HIS) \u2013 which can include Health Information Exchanges (HIEs), IIS, Electronic Health Records (EHRs), and others \u2013 provide healthcare providers with immunization evaluation and forecasting tools designed to automatically determine the recommended immunizations needed when a patient presents for vaccination. These recommendations are developed by the Advisory Committee on Immunization Practices (ACIP). ACIP is a federal advisory committee responsible for providing expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) and the Secretary of the U.S. Department of Health and Human Services (DHHS) on use of vaccines and related agents for control of vaccine-preventable disease in the United States. Recommendations include but are not limited to age for vaccine dose administered, number of doses, dosing interval, risk factors, precautions, and contraindications.After ACIP recommendations are published, technical and clinical subject matter experts (SMEs) work to interpret and integrate them into their evaluation and forecasting engines. An example of an evaluation and forecasting engine is a tool an IIS might use to alert a physician that a presenting child is overdue for a Measles, Mumps, and Rubella (MMR) vaccination. New ACIP schedule changes are currently communicated only through clinical language, in publications like the Morbidity and Mortality Weekly Report (MMWR) and the Epidemiology and Prevention of Vaccine-Preventable Diseases ("The Pink Book"). The translation of that clinical language into technical logic that is processed within evaluation and forecasting engines is a time-consuming and complex process that happens mostly independently within the different HIS. Due to the challenge of interpreting clinically written ACIP recommendations, clinical decision support (CDS) engine outputs often vary and do not always match the expectations of clinical SMEs.logic-spec-acip-rec-4.3.pd

Disparities in Anti-Vaccine Views: Twitter Contents Analysis During World Immunization Week

The emergence of social media platforms provides an opportunity to exchange health-related information and express opinions on health-related issues. The researchers\u27 adoption of social media contents in the health research domain is attributed to the easy accessibility of a large number of perspectives and views in limited time and less effort. The analysis of social media contents, such as Twitter, allows researchers to examine people’s perceptions about specific crucial topics, such as vaccinations. The researcher aims to collect and measure data on the current motivations and reasons for opposing vaccination and understand vaccine-skeptics claims against vaccines. This study presents a descriptive quantitative analysis of the contemporary claims against vaccines during the World Immunization Week 2019. The researcher collected 27266 vaccine-related tweets from April 24 – 30, 2019. These tweets were analyzed to characterize key terms and their connections, classified into pre-defined groups, and sentimentally analyzed to identify the anti-vaccine tweets. The tweets analysis captures the anti-vaccine tweets and groups them into themes that were initially created after a manual scanning of a 6,000 tweet sample. The classification and sentiment analyses resulted in 4,181 tweets out of the collected tweets being distributed over eight themes of anti-vaccine views. The results highlight vaccine-skeptics perceptions and motivations not to vaccinate their children. They also view the vaccine\u27s biggest concern among posters which is worrying about vaccine\u27s side effects. The analysis also reveals the anti-vaccine tweets timeline during the World Immunization Week, the top hashtags that were associated with the tweets, and the geo-location posting of these tweets worldwide. The interdisciplinary study of health-related issues in Twitter leads to a better understanding of public concerns and views which will result in greater response to such critical health issues and find solutions to raise health awareness among societies. Advancing the knowledge of methods and patterns of social media contents analyses is becoming an essential tool for the public health domain. Working toward this goal, this study used emerging data analysis approaches to reveal opinions and views against vaccines from Twitter contents to help find solutions to this contemporary critical health issue

Addressing Human Papillomavirus Vaccination in Primary Care Pediatrics

Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Despite most common transmission, HPV immunization in adolescents remains below target rates of 80% as outlined by Healthy People 2020 Objectives. Nearly all individuals will contract HPV during their lifetime. The purpose of this project was to educate providers on successfully promoting HPV immunization in adolescents utilizing evidence-based methods. The health belief model (HBM) was the theoretical underpinning utilized to teach providers on discussions about 9vHPV immunization with parents of adolescents. The practice focused question explored whether an education program using concepts from the HBM would increase provider perception of preparedness on recommending Gardasil 9 immunization in adolescents. Convenience sampling was utilized to recruit participants. There were 9 out of 25 providers that attended the educational in service with 8 completing the continuing education evaluation tool. Participants included providers who are affiliated and hold privileges with the health care system. Survey Monkey was used to analyze the participant evaluations. All the participants found the educational information relevant to increasing their perception of preparedness on recommending Gardasil 9 immunization in adolescents. The findings suggest that providers would benefit from training on recommending HPV immunization in adolescents. Continued training would help enhance timely immunization rates that could decrease cancer rates and reduce associated healthcare cost, in turn promoting population health and positive social change

Is There a Fundamental Right to Privacy When an Educational Institution Requires a Student to Disclose Proof of His or Her Vaccination Status?

In 2020, the coronavirus disease (“COVID-19”) dominated the world. Although the public has progressively become more informed about the disease and how to safeguard itself, challenges persist as there is still much unknown. Aside from wearing masks, social distancing, and despite its undetermined consequences, the COVID-19 vaccination has emerged as a primary solution to substantially reducing the incidence and severity of the virus in our country. Many COVID-19 vaccine mandates were initiated once three pharmaceutical and biotechnology companies including Pfizer-BioNTech, Moderna, and Johnson & Johnson received Emergency Use Authorization from the Food and Drug Administration (“FDA”)

Advisory Committee on Immunization Practices (ACIP) summary report : October 23-34, 2013, Atlanta, Georgia

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Behavioral and Epidemiological factors behind Vaccine Hesitancy in The United States

Vaccines are by far the most significant achievement in public health over the last century, saving millions of lives. Vaccination provides immunity as well as protection against certain infectious diseases, and the majority of vaccines contain a weakened version of a disease-causing microorganism. But why do people continue to be skeptical of vaccines and what they can do to improve their health? Vaccines, in general, can evoke strong biological, cultural, social, and political reactions all over the world, not just in the United States. Vaccine history is extremely complex, and it is still ongoing today as new diseases emerge. The anti-vaccine movement has existed since the development of vaccines by Edward Jenner in 1796. It is critical to understand the past and continue building on what we know today through new vaccine research & technology. Diseases today are far more complex than in the past, but advances in technology have enabled us to combat diseases in ways we could never have imagined. The war on diseases is never-ending and will continue as long as humans exist. But why are people becoming more hesitant to get vaccinated than ever before, or refusing to get vaccinated at all? Today, the ongoing pandemic and the new COVID-19 vaccine are the main topics on which vaccines are being discussed in major news outlets. Many people have turned to the vaccine to protect themselves from the virus, but many are still skeptical that the vaccine is safe or effective. This has pushed vaccine hesitancy to the forefront of the pandemic, and it has become a hot topic not only in the United States but in countries all over the world

Meeting of the Advisory Committee on Immunization Practices (ACIP), November 2-3, 2021 summary minutes

summary-2021-11-2-3-508.pdf20221156